Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.
Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.
Foot Ankle Surg. 2021 Jan;27(1):20-24. doi: 10.1016/j.fas.2020.01.002. Epub 2020 Jan 9.
Scarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia.
We enrolled 106 patients (118 feet) and assessed patients' pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Three different methods of measuring metatarsal length were compared and early postoperative complications noted.
Hallux valgus angle decreased significantly by an average of 18.7 degrees and the intermetatarsal angle by 7.8 degrees. Using three methods of measuring metatarsal length, all showed significant shortening of the first metatarsal. Mean relative lengthening of the second metatarsal averaged 0.45mm. The Coughlin method showed the highest interrater reliability (ICC=0.96).
Significant reduction of the hallux valgus angle and intermetatarsal angle was demonstrated with a low complication rate. There was significant shortening of the first metatarsal. The Coughlin method clearly demonstrated an excellent interrater reliability.
Level IV.
Scarf 截骨术已广泛应用于治疗拇外翻畸形，以恢复第一跖骨的轴向方向。本研究的目的是介绍我们在拇囊炎重建方面的放射学结果，确定早期随访中的手术并发症，并评估手术后第一跖骨缩短的程度，因为这可能是术后跖痛的一个原因。
我们纳入了 106 名患者（118 只脚），并在负重 X 线片上评估了患者术前和术后的拇外翻和跖骨间角测量值。比较了三种不同的跖骨长度测量方法，并记录了早期术后并发症。
拇外翻角平均显著降低 18.7 度，跖骨间角降低 7.8 度。使用三种跖骨长度测量方法，均显示第一跖骨明显缩短。第二跖骨的平均相对延长为 0.45mm。Coughlin 法显示出最高的组内相关系数（ICC=0.96）。
本研究显示，拇外翻角和跖骨间角显著降低，并发症发生率低。第一跖骨明显缩短。Coughlin 法明显显示出良好的组内可靠性。
IV 级。
